Raffaella Messina

• MD
• Assistant lecturer at University of Bari Aldo Moro

Purpose Acute bacterial rhinosinusitis (ABRS) and acute otitis media (AOM) are common diseases in pediatric populations that rarely lead to intracranial infection and/or orbital complications. The incidence of these complications has increased in recent years and the main aim of this study is to analyze the tendency of this increase during the pand...

Background Early reconstruction of the skull represents the gold standard after resection of bone infiltrating cranial tumors. Customized hydroxyapatite porous ceramics are an excellent option for covering skull bone defects. The authors illustrate the surgical technique and investigate the effectiveness of the "one-step" procedure in terms of aest...

Aquaporin-4 (AQP4) and its extended isoform, AQP4ex, are crucial for regulating brain water homeostasis. Mis-localization of these isoforms is implicated in various brain tumors, including glioblastoma multiforme (GBM). This study explores AQP4 isoform expression and localization in Pilocytic Astrocytomas (PA), a circumscribed astrocytic low-grade...

The aim of this systematic review is to analyse the role of hearing preservation surgery for vestibular schwannoma. The complications and hearing outcomes of the single surgical techniques were investigated and compared with those of less invasive strategies, such as stereotactic radiotherapy and wait and scan policy. This systematic review and met...

BACKGROUND The signal transducer and activator of transcription 3 (STAT3) shows a key role in regulating the anti-tumor immune response. STAT3 is activated in cancer cells and in the tumor microenvironment thus inhibiting crucial immune regulators expression and promoting immunosuppressive factors. Brain metastatic cells sustain a pro-metastatic si...

Mesenchymal tumors of the central nervous system (CNS) include numerous entities, with different pathological features and biological behavior. Mesenchymal non-meningothelial tumors are rare and comprise neoplasms that are exclusive to the CNS or show peculiar features when occurring in the CNS compared with other sites. Within this group there are...

Primary Central Nervous System Lymphoma is a rare extranodal non-Hodgkin lymphoma, primarily arising in brain and spinal cord tissue, leptomeninges and vitreoretinal eye. Pediatric PCNSLs are even rarer. We describe the case of a boy presenting with seizures and a suspected brain meningioma, but a final diagnosis of ALK+ Anaplastic Large Cell Lymph...

Glioblastoma represents adulthood's most frequent and aggressive primary brain tumor. The gold standard in the treatment remains radical resection followed by concomitant chemo-radiation therapy according to the STUPP protocol. Despite the therapy, the prognosis remains poor. Thus, one main objective in neuro-oncology research is identifying novel...

Background and objective: The identification of mutation hot spots in the isocitrate dehydrogenase (IDH) genes is one of the most important cancer genome-wide sequencing discoveries with relevant impact in the treatment of some orphan tumors. These genes were mostly found mutated in lower-grade gliomas (LGGs), acute myeloid leukaemia (AML), myelod...

Background: Vestibular Schwannomas are benign tumors arising from the VIII CN. Surgical treatment is indicated in case of tumors larger than 2.5 cm in the cerebellopontine angle or in the case of cranial nerve dysfunction. The aim of the present study was to evaluate the QoL by means of the PANQOL questionnaire in a group of surgically treated pati...

Background Aneurysmal subarachnoid haemorrhage (aSAH) is a complex neurovascular syndrome with profound systemic effects, associated with high rates of disability and mortality. Delayed cerebral ischemia (DCI), which encompasses all neurobiological events occurring in the subacute-late stage post-aSAH, has a complex pathogenesis and can occur even...

Background Pituitary stalk hemangioblastomas (PSHBLs) are rare vascular tumors and their surgical removal is challenging due to the proximity with several fundamental anatomic structures including the pituitary stalk, third ventricle, hypothalamus, and optic pathways. To date, only few descriptions of transcranial and transsphenoidal approaches for...

AQP4ex is a recently discovered isoform of AQP4 generated by a translational readthrough mechanism. It is strongly expressed at the astrocyte perivascular endfeet as a component of the supramolecular membrane complex, commonly called orthogonal array of particles (OAP), together with the canonical isoforms M1 and M23 of AQP4. Previous site-directed...

Glioblastoma multiforme (GBM) is characterized by a remarkable cellular and molecular heterogeneity that make the behavior of this tumor highly variable and resistant to therapy. In addition, the most serious clinical complication of GBM and other brain tumors is the development of vasogenic edema which dramatically increase the intracranial pressu...

Central precocious puberty (CPP) is a condition that causes early gonadotropin-dependent sexual development; CPP is idiopathic in girls in most cases, whereas more than 50% of boys have an identifiable etiology. We conducted a qualitative systematic review following the ENTREQ (enhancing transparency in reporting the synthesis of qualitative resear...

Meningioma is one of the most frequent neoplasms of all in the central nervous system. Different variants are known, and of these some have peculiar characteristics, both from a morphological point of view and from a biological point of view. Here, we present a rare case of relapsed papillary meningioma in a young patient, focusing on histological...

Purpose: To evaluate factors influencing clinical and radiological outcome of extended endoscopic endonasal transtuberculum/transplanum approach (EEA-TTP) for giant pituitary adenomas (GPAs). Methods: We recruited prospectively all consecutive GPAs patients undergoing EEA-TTP between 2015 and 2019 in 5 neurosurgical centers. Preoperative clinical...

Background and Objectives The study aimed to evaluate the impact of dalbavancin therapy on both hospital length-of-stay (LOS) and treatment-related costs, as well as to describe the clinical outcome, in a retrospective cohort of patients with diverse Gram-positive bacterial infections, hospitalized in different specialty Units.Methods From July 201...

Li-Fraumeni syndrome (LFS) is a rare high-penetrance and autosomal-dominant pathological condition caused by the germline mutation of the TP53 gene, predisposing to the development of tumors from pediatric age. We conducted a qualitative systematic review following the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Researc...

Tentorial dural arteriovenous fistulas are rare causes of intracranial hemorrhage and nervous tissue venous congestion. Due to their extensive arterial supply and difficult transvenous endovascular navigation, they are frequently managed microsurgically. Precise identification of the venous drainage, its retractorless exposition, and real-time veri...

Intracranial arteriovenous fistulas, rare causes of spontaneous intracerebral bleeding, are direct communications between an arterial feeder and an arterialized vein that drains a normal brain. Arteriovenous disconnection is the only effective treatment for this type of vascular malformation, which is often reached microsurgically due to the diffic...

Purpose To analyze the outcome after untethering surgery in patients with spinal dysraphism (SD), with or without associated anorectal malformation (ARM). Methods Patients operated on for SD, with (Group A) or without (Group B) associated ARM (1999–2015), were included. The post-operative outcome was analyzed in the two groups in terms of improvin...

Purpose: Mesenchymal chondrosarcoma (MCS) is an aggressive variant of chondrosarcoma and is a rare tumor, particularly within the pediatric population. Commonly, MCS originates in the bone, but it can also arise in extraskeletal sites, such as the brain and the intraspinal area. Due to the rarity of this tumor, there are no guidelines for its opti...

Purpose: To describe the association of anorectal malformation (ARM) and spinal dysraphism (SD) in terms of impact on the management of SD and embryogenetic implications. Methods: Patients with SD associated with (A) or without (B) ARM were included. The two groups were further divided into operated on (A1/B1) or not (A2/B2) for SD. Groups A and...

Langherans' cell histiocytosis (LCH) is a rare disease mostly affecting children in the first decade of life. As clinical presentation is extremely heterogenous, a prompt diagnosis may be challenging, sometimes leading to a diagnostic delay, especially when the disease involves a single site. Herein, we report a case of a child with an unusual pres...

OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy...

Background: Diffuse Intrinsic Pontine Glioma (DIPG) is a childhood tumor with dismal prognosis. Emerging molecular signatures have paved the way for stereotactic biopsy in selected Centers. We present our experience in DIPG stereotactic needle biopsy using the Robotic Stereotactic Assisted system (ROSA™) in a consecutive pediatric series. Methods...

Introduction: Intrameatal cochleovestibular neurovascular conflict is a rare condition with specific clinical and therapeutic implications. Although surgery is commonly indicated in other neurovascular conflicts, for this subset of patients there is little evidence to guide treatment decisions. Moving from a case description, we performed a review...

Background: Kabuki syndrome is a rare disorder characterized by the association of mental retardation and postnatal growth deficiency with distinctive facial appearance, skeletal anomalies, cardiac and renal malformation. Two causative genes have been identified in patients with Kabuki syndrome. Mutation of KMT2D (MLL2) was identified in 55-80 % o...

Background: Hardware-related complications frequently occur in deep brain stimulation. Microscopy and spectroscopy techniques are effective methods for characterizing the morphological and chemical basis of malfunctioning DBS electrodes. A previous report by our team revealed the morphological and chemical alterations on a malfunctioning explanted...

The importance of a holistic approach during therapies for challenging diseases is supported by a variety of sources. While aggressive surgery, when feasible, followed by chemo-radiation and then chemotherapy is the standard of care for patients with GBM, diet and nutrition might be important supportive measures to improve treatment efficacy. In th...

Background Extraventricular neurocytomas (EVNs) are rare parenchymal brain tumors, distinct from central neurocytomas that are typically located within the supratentorial ventricular system. Seizures and headache represent the most common symptoms of extraventricular neurocytomas in the cerebral hemisphere both in adult and pediatric population.Cas...